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Caufman
May 7, 2007
I worked for a disability law firm as a non-attorney representative before burning out. This is my experience with Social Security Disability Law.

It doesn't surprise me to learn that the lawyers you spoke with do not handle Social Security disability cases. In my experience in my region (Pacific NW), law firms either specialize in disability cases or they do not touch it at all. I've only heard of a few lawyers, usually ones just starting out, who handle different types cases that include disability cases. The firm I worked for exclusively practiced disability law and would refer out other legal issues to other attorneys.

You may have been explained that there are four levels in the claims process: Initial Application, Reconsideration, Hearing, and Appeals Council. The plurality of cases that win do so at the hearing level. Most claims are denied at the Initial level, and the office that makes that determination (Disability Determination Services, which are state-level agencies) is not required and does not give a detailed explanation for why you've been denied. You then have the option to file your first appeal and move to the Reconsideration level. Your claim goes back to DDS to a new analyst and you are even more likely to get denied. You then can appeal to request a hearing, and here is where your odds may finally turn in your favor. On average, in our region, it takes people about 1.5-2 years from applying to going through the appeals and getting in front of a judge.

In my opinion, the single biggest determinant about your chances of success is the judge that gets picked to hear your case. Some judges approve ~80% of their cases. Some approve ~%15. This is one of the most frustrating parts about the hearing system. No one could explain to me how this was fair. The statistics on Social Security Administrative Law Judges is also publicly available at https://www.disabilityjudges.com. If you are denied by an ALJ, they are at least required to provide a detailed explanation for their reasoning.

If you do not get approved at the hearing level, you may appeal your case to the Appeals Council. In my opinion, the AC is a waste of time. An appeal will wait for like a year for a ruling from the AC, the vast vast majority of appeals are denied. In my 3.5 years working at the firm, I saw one favorable appeal, and that just means the case gets sent back for a hearing, usually in front of the same ALJ that denied the case. The AC wastes time but legally a case must go through the AC before it can potentially be taken to U.S. District Court. Not every firm takes a case to USDC, since it's a different level of law.

You can hire an attorney at any time. The fee structure is the same across every disability firm because the rules are set by SSA. If you win, typically the lawyers will get 25% of your past-due amount (commonly called the backpay) with a cap at $7200, (used to be $6k). I say typically because there are exceptions (if more than one firm worked on your case, or if your case went to Federal court, the fee is more complicated). It generally does not affect the fee whether you hire the firm at the beginning of your case or at the hearing level. You can petition the ALJ to lower the fee to your lawyer if you felt that they didn't put in very many hours into your case after winning, but it's fairly easy for a firm to counter-argue that they should get the full 25% or the cap by showing an itemized breakdown of hours worked on your case and setting a high hourly fee for their time.

Most of our clients hired us before they even began applying for disability, so we would help complete the application with them. We would track their case, file their appeals, and prepare them for their hearing. If they didn't win at the hearing, we would file their appeals to the AC. When the Appeals Council would almost invariably deny their appeal, we would consider taking their case to U.S. District Court on a case-by-case basis.

A minority of our clients would come to us at the hearing level. The story I would hear is that these clients applied on their own, filed their own appeals, and finally went before an ALJ unrepresented. The ALJ would then strongly recommend that they get a lawyer, and the ALJ would postpone their hearing until they can hire one. I don't think an ALJ can force you to get a lawyer, but you may really want to get one. The hearing office does not even request medical records, so they may not even have your complete file at that point. It's your responsibility (or your lawyer's if you hire one) to submit your complete medical record.

In terms of what can help your case, getting a supportive medical provider on your side can really help. Have you talked to your treatment providers about applying for disability? Are they supportive of your decision? If so, you may want to get them to support your case. They can write a letter, but what may be even more helpful to a disability case is if they would complete a Residual Functional Capacity questionnaire on your behalf. Law firms have these RFCs on hand, but you can also find free ones online. The more detailed the treatment provider is on their RFC, the more persuasive it will be for an ALJ. And even if you get a lovely ALJ who denies the vast majority of their cases, the stronger your overall medical evidence is, the weaker their justification for denying you will be, and therefore the stronger your chances will be on ultimately winning on an appeal in Federal court.

So it may behoove you to hire an attorney early because (a) statistically, you will likely need to go to the hearing level to win your case, and (b) a law firm will file your appeals for you, and (c) a good law firm will actually try to actively strengthen your case early and work with you personally on hearing prep. Psychologically, it can also be nice to just have an organization that is on your side. The disability claims process is not supposed to be adversarial, but it's clear that SSA isn't heartbroken if you give up on your case, but at least hiring a lawyer means you have someone who, if not morally, is at least financially invested in seeing you win.

It is a needlessly broken system, and I feel you for having to go through it. Best of luck, please don't miss your appeal deadlines, and illegitimi non carborundum

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